Placebo Controlled Trial of Familiar Auditory Sensory Training for Acute Severe Traumatic Brain Injury

Abstract

1.Participant will be able to explain that the Familiar Auditory Sensory Training (FAST) protocol is a passive auditory sensory stimulation intervention.2.Participant will be able to explain therapeutic effects of FAST protocol for severe TBI3.Participant will be able to explain changes in volumes of neural activation corresponding with FAST intervention and Placebo relative to heathy controls Double Blind Randomized Placebo Controlled Trial Community and Inpatient rehabilitation 15 subjects in vegetative (VS) or minimally conscious (MCS) states on average 70 days after TBI. Eight assigned to the experimental FAST and 7 to the Placebo. Placebo Silence or FAST, which is a passive familiar auditory sensory stimulation protocol comprised of familiar people telling stories about memorable events. All subjects received 168 doses of assigned interventions provided four times daily for six weeks. Coma-Near-Coma scale and volumetric activation measured with functional imaging according to pre-selected regions. Mixed-effects models indicate that FAST group had significantly quicker recovery and more functioning. Mean CNC weekly slope difference is -0.63 points (p = 0.0022) and endpoint CNC indicates 6 points of more functioning. All subjects had significant (p < 0.05) neural activation within Heschl's Region. Examination of significant changes (p < 0.05) in functional activation when listening to Familiar (FV) and Nonfamiliar (NFV) voices telling the same story indicate FAST subjects had significantly (p < 0.05) increased pre-frontal (PF) activation to FV with no changes to NFV. Placebo subjects had signficantly decreased PF activation to FV and NFV. FAST subjects had significantly decreased Heschl's Region activation to NFV. Placebo subjects activation did not change within Heschl's. FAST is associated with improved functioning for persons in VS or MCS after TBI. Completed activation analyses indicate increased PF activity to FV with decreased activity in Heschl's to NFV suggesting enhanced engagement and processing when listening to FV.